高場強iMRI在經(jīng)鼻蝶入路垂體瘤手術中的應用研究.pdf

1、天津醫(yī)科大學碩士學位論文高場強iMRI在經(jīng)鼻蝶入路垂體瘤手術中的應用研究姓名：賀中正申請學位級別：碩士專業(yè)：臨床醫(yī)學；外科學神經(jīng)外科指導教師：岳樹源201205天津醫(yī)科大學碩士學位論文AbstractObjectiveTodiscusstheapplicationofthehigh—fieldintraoperativemagneticresonanceimaging(iMRI)associatedwithneuronavigation

2、systemintransnasalsphenoidalsurgeryforpituitaryadenomasMethods38pituitaryadenomaswereresectedvianasalsphenoidalapproachwithassistanceoftheGESigna15TintraoperativemagneticresonancesystemassociatedwithBrainLABneuronavigati

3、onsystemAndiMRIscanningswereperformedtomakesurethatwhethertherecectingextendoftheadenomasneedexpandingornotFortheadenomaswhichweretotallyrecectedorrecectedtoachievethepreoperativepurpose，thenfinishedtheoperationIftheaden

4、omasremained，andneededfurtherresecting，thenexpandedtheresectingextentandperformediMRIscanningsRepeatedtheprocessaboveuntilthetumorsweretotallyresectedTheclinicalmaterials，iMRI’Simagingqualityanditsinfluenceonthesurgicalp

5、rocessandresultswereanalyzedResultsThetimesofintraoperativescanningrangedfrom2to3perpatient，averaging211041timesThescanningtimewas35minandaddingthepackagingandtransportingprocess，thewholeprocedurelasted1520minutesPosingt

6、heposition，fixingtheheadrestandnavigationregisteringcost3240minina11Sothetotaloperationtimewasextendedto4760min，averaging5120066minTheiMRlwasusedtoscanningandcollectingpictures，andshowedthat11caseswererevealedresidualtum

7、ortissueexisting8ofthe11continuedtobetotallyremovedundernewnavigationdataafterupdatingtheneuronavigationplans(withoutanewregisteration)whileother3casesweresubtotallyresectedbecausetheadenomasweretenaciousandadheredclosel

8、ytothesignificantanatomystructuressurroundingandhadachievedtheplanedresectingextentFinallywiththeuseofthisiMRIsystem，thetotallyresectedrate(TRR)oftheadenomasincreasedfrom7105％(27／38)to9211％(35／38)，improved2106％(8／38)，X2=